They want to turn down a federal offer to expand Medicaid, the federal and state health insurance program for the lowest-income families, to cover 500,000 more people in the state. They’re turning it down despite the federal government’s offer to pick up 100 percent of the cost from 2014 to 2016 and 90 percent afterward.

They want to reject $14.8 billion in federal payments from 2014 to 2021 to insure those who would be newly eligible for Medicaid.

They want to forgo the effect that extra federal spending would have on jobs in a state where the unemployment rate is above 9 percent.

They want to dismiss an opportunity to improve the health of low-income people in a state that ranks 38th in negative health outcomes such as cancer, infant mortality, diabetes and cardiovascular deaths.